An article in the New York Times Magazine from June 17th by Tina Rosenberg profiles the conviction of a pain doctor, Dr. Ronald McIver, for drug trafficking and offers a nuanced analysis of the complexities of his trial. According to the article, there were some patients that were using McIver's prescriptions for reasons other than for pain, but there were also testimonies from other patients who claim that McIver was the only doctor who offered them any real relief from their pain.

The author concludes that the Drug Enforcement Agency, (DEA) should follow their own standard, that "for a criminal prosecution to occur, a doctor must have broken the link between the opioid and the medical condition." Reckless behavior, or being otherwise incompetent as a physician, should be dealt with by state medical boards.

The author admits that some 'pill-mill' doctors might get away with their crimes under such a standard. However, this might be a small price to pay to ensure that pain patients, including cancer patients, get the relief they need and prospective physicians are not scared off from pursuing the specialty of pain management.

A Mayo Clinic College of Medicine study finds more than 20 percent of cancer patients in chronic pain do not ask for pain medicine or help with pain management. The researchers, who refer to these patients as "silent sufferers," admit they do not report pain to their physician. Researchers of this study say that the reasons for not seeking pain relief are unclear, but speculate some of the reasons may be poor previous experiences with pain care, perceived lack of effective treatments, and barriers to health care from a lack of medical insurance. 

As a cancer survivor with long-term chronic pain issues, I can share a perspective and experience not clearly stated in this study, that other cancer patients with chronic pain know all too well, when seeking pain relief from physicians. There are no easy answers when it comes to pain management. The most effective pain management relief comes from the prescription of narcotic medication. Regular use of narcotic medication to relieve pain may lead to drug dependence. Narcotic pain medication is heavily monitored by the DEA, and many physicians are reluctant to draw attention to their practice by prescribing narcotic pain medication. My guess is that the 20 percent of cancer patients with chronic pain gave up, somewhere in the process, after being put in a position of being made to feel like a drug addict, or having to fight for effective medical care for a real medical condition. The pain becomes easier to deal with, than the ordeal of trying to get help for pain relief.